Update on Alyssa

For those that aren't aware, Alyssa has spent the last three days in the hospital. She went to the doctor last Thursday after having three straight days of diarrhea. The doc recommended we change her formula and supplement her regular feedings with Pedialite to maintain hydration.

Alyssa is no stranger to new formulas. Since literally the moment she was born she has had a problem with spitting up. She visited the doctor in February for that issue. He sent her for an ultrasound to rule out any defects related to her esophageal valve and prescribed a low dose of Reglan to help her stomach empty out faster. The problem persisted, however, and Alyssa continued to eat, burp, relax, then suddenly--sometimes up to an hour later--spit up. The fact this was occurring "at rest" troubled her doctor. We cycled through half a dozen different types of formula. Enfamil AR, which is fortified with rice, seemed to help a little, so we settled on that and discontinued the Reglan, which seemed to make things worse.

We were prepared to accept that Alyssa is just a fussy baby and hoped she would eventually grow out of her reflux condition when, ten days ago, she developed diarrhea. After her first visit to the doc for the new symptom, nothing changed. Jen took her back to the doc Monday for a follow up. She had lost three ounces and was beginning to show signs of mild dehydration. Her doc ordered blood tests and a stool sample and sent her home. Tuesday morning, he called and said he would like to admit her overnight to run some tests. Jen packed a bag, dropped off Kaitlyn with the neighbor and took Alyssa to the hospital. They did another ultrasound and an upper GI to rule out any abnormalities or blockages. Both tests came back negative.

Wednesday was a waste, due to mis-communication and, in my opinion, poor practice of medicine. When I say "poor practice" I do not mean "malpractice", because I do believe that Alyssa has and continues to receive the best quality of care in the world. What happened Wednesday was the poor execution of an ultra-conservative strategy of medical practice that ultimately will increase the cost of this hospital visit. The on-call doctor, a young, tall, skinny man with an Eastern European accent, initially decided to bring in a GI specialist to consult on Alyssa's case. However, Wednesday morning, after a single dose of an acid reflux drug that typically takes three days to kick in, Alyssa was on a marathon stretch of hours without spitting up.

Dr. Ukraine canceled the consult.

By mid-afternoon when he revisited Alyssa and realized the lack of symptoms was most likely a coincidence, it was too late to get back on the GI doc's calendar. Doctor Ukraine was paged to another hospital and we didn't see him the rest of the day. That left us with the nursing staff. The day nurse said the GI doc was definitely going to come see us in the morning. The night nurse said the doctor was still on the fence and had not yet reordered the consult. Meanwhile, we're racking up reward points with the Baptist Health System. I hope this isn't the future of health care.

Thursday we got back on track. Dr. Ukraine was off and a new, more seasoned doctor was on duty. He witnessed Jen with Alyssa for five minutes and agreed the child clearly had acid reflux. He ordered a reflux test and suggested that it may also be necessary to do a pH test, requiring a probe inserted through Alyssa's nose down her throat and into her stomach for 24 hours. A few hours after the reflux test was completed, the GI specialist paid us a visit. The reflux test confirmed that Alyssa's stomach is slow to empty and she is experiencing reflux (duh). Thankfully, she is not a fan of the pH test for infants. Her belief is that none of the medications tried so far have been of the correct dose or been given sufficient time to work. She also believes the diarrhea may in fact be a symptom of the reflux and not a viral infection since Alyssa's blood tests came back normal. She laid out a detailed plan of treatment involving pharmaceuticals as well as changes to Alyssa's eating and sleeping habits. Hopefully this course of treatment will prove successful after a few days and no further action will be required.

In the meantime, Jen and Alyssa are spending their third night in the hospital. Alyssa's dehydration has already improved and she no longer has an IV. If she shows signs of weight stabilization tomorrow our hope is that she will be discharged home in time to color Easter eggs Friday night. We'll follow-up on an outpatient basis with the GI doc next week...who doesn't take our Cadillac insurance plan by the way, so phone lines are open and operators are standing by to accept your donations. I will be returning to "work" tomorrow, although I suspect most of my day will revolve around making sure this little pleasure cruise--which will undoubtedly run in the four or maybe even five digit range--is 100% covered sans a modest deductible.

For the latest updates on Alyssa's condition, follow me on Twitter (SLOengineer) or check my Facebook. Thank you to all who have sent your prayers, words of encouragement, and offers for help. It means a lot and we truly appreciate it. I am sorry that I haven't been able to accept all your phone calls or respond to every comment/email. I've been busy trying to get in touch with Dr. Gregory House. If you have his number, can you text it to me?

Things K Does #9

Dear Haters, How About A Drinking Game?

Dear Haters,

I've held off on the updates lately because I desperately did not want to give you the fodder you so love. But alas, I cannot hold back any longer. Without further ado, here's the status of life in the Genovese household with two under two.

Nobody in my house sleeps. Not even the dog. We made the decision a couple weeks ago to take away Kaitlyn's goo (i.e., pacifier, binky, dummy tit). The Internet gods warned us of "3-5 nights" of screaming fits. They were dead wrong. On a good night we keep it down to about five minutes. This is week three. On top of that, the precious toddler has definitely begun her terrible two's, which is most apparent at bedtime--with or without a goo. The routine usually goes something like this:

1. Child makes the rounds through the house, kissing everyone from Mommy to the doggy good night.
2. Walk upstairs to child's room. Daddy (or mommy) coaxes her into bed while she asks to be held. "No, I can't hold you, but put your head down and...
3. we'll read 'Moon'". "Okay" she says forlornly.


4. Read "Good Night, Moon". Point to the red balloon, the phone, the comb like daddy's, and the mouse. Giggle at the old woman whispering "hush".
5. Child asks to read Barney. Parent says no.
6. Child asks for milk. Parent allows "just a sip", striking a bargain with her as long as she stays in her bed.
7. By the time parent returns upstairs with milk, child is out of bed. Repeat step two.
8. I'll let you drink some milk. Child pretends to sip on milk cup. Parent takes milk away, kisses child good night. Child whimpers and asks for "box".
9. Parent winds up Beauty and the Beast music box. Child exclaims "I DO IT!". Parent lets child flip music box "on".

10. Parent makes deal with child to stay in bed. Reminds child that she has her pillow, kitty, big bear, other bear, and blankie. Parent tucks child in firmly, kissing her on the head.
11. Child begins to cry, pleading for a hug. Parent's heart melts, gives child hug.
12. Child won't let go, asks to "hold" while fighting back tears. Repeat step two.
13. You'll get a mint in the morning, but you have to stay in bed. Child whimpers "OK".
14. Parent moves toward door. Child asks for "Moon". Parent thinks this sounds familiar, continues out door, latching it closed on the way out.
15. Child wails, gets out of bed, lays on floor behind door and continues screaming until she falls asleep.

With child #1 in bed, it's time for the rest of the household to turn in for the night. Baby Kaitlyn slept through the night as soon as she came home from the hospital. Baby Alyssa parties all night long. Her routine goes like this:

1. Child cries. Parent changes diaper, swaddles child, makes bottle, feeds child.
2. Parent burps child.
3. Child appears to be asleep. Parent puts child in bassinet.
4. Child spits up...everywhere. Burp cloth is on rocking chair.
5. Parent curses.
6. Parent changes child's clothes, re-swaddles, sits in chair to lull child back to sleep
7. Repeat step 3.
8. Parent crawls into bed slowly, stops. Child still asleep.
9. Parent pulls up covers, stops. Child still asleep.
10. Parent lays head on pillow, closes eyes.
11. Repeat step 5, then go to step 1 and proceed.

I suppose if we live streamed this choreography on the Internet it could make for a fun drinking game. Every time you hear a child cry, drink. Every time a parent curses, make someone else drink. Poopy diaper? Take a shot. Whoever is not drunk by the end of the game gets to babysit tomorrow.

Now, where did I set my drink...